Individual provider Active NPI

George Paul Hebbler III, PT, DPT

  • Physical Therapist
  • Saint Augustine, FL
National Provider Identifier
1154750396
Registry record updated Jun 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT28759 Issued in FL
Practice address
4320 A1A S Ste 7
Saint Augustine, FL 32080-7436
Phone
(904) 679-3449
Fax
(904) 679-3436
NPI assigned
Nov 7, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT28759 FL Primary

Addresses

Primary practice location

4320 A1A S Ste 7
Saint Augustine, FL 32080-7436

Mailing address

105 Mariner Health Way Ste 213
Saint Augustine, FL 32086-3251
Phone (904) 679-3449

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190821001584 FL Practitioner - Physical Therapist in Private Practice 4688902232 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Augustine Rehabilitation Specialists LLCGroup PAC ID 8426107293, 38 clinicians

Practice addresses (Care Compare)

105 Mariner Health Way
Suite 213
St Augustine, FL 32086-3251
Phone (904) 217-4259

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT28759FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Augustine Rehabilitation Specialists LLC Physical Therapist CurrentSince Jul 15, 2019 Accepting new patients
Saint Augustine Rehabilitation Specialists LLC Physical Therapist PastSince Mar 11, 2025 Accepting new patients

Locations

1711 Lakeside Ave
Ste 3
Saint Augustine, FL 32084
Phone (904) 201-1080

105 Mariner Health Way
Ste 213
St Augustine, FL 32086
Phone (904) 217-4259

4320 A1A S
Ste 7
St Augustine, FL 32080
Phone (904) 217-4259

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1154750396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MARINER HEALTH WAY STE 213",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320863251",
            "telephone_number": "904-679-3449",
            "fax_number": "904-679-3436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 A1A S STE 7",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320807436",
            "telephone_number": "904-679-3449",
            "fax_number": "904-679-3436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBBLER",
        "first_name": "GEORGE",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-07",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT28759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.